Glynn Judith R, Caraël Michel, Buvé Anne, Anagonou Séverin, Zekeng Léopold, Kahindo Maina, Musonda Rosemary
Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2004 Jan;9(1):4-14. doi: 10.1046/j.1365-3156.2003.01168.x.
The association between educational attainment and risk of HIV infection varies between populations and over time. Earlier studies in sub-Saharan Africa have found that those with more education are at increased risk of HIV infection.
We investigated the associations between general schooling and both HIV and herpes simplex-2 (HSV-2) infection using data from the multicentre study on factors determining the differential spread of HIV in four African cities. Cross-sectional general population studies were conducted in 1997-1998 in Cotonou (Benin), Yaoundé (Cameroon), Kisumu (Kenya), and Ndola (Zambia), including about 2000 adults in each city.
There was no association between schooling and HIV infection in men or women in Kisumu or Ndola. Women in Yaoundé and men in Cotonou, with more schooling, were less likely to be HIV positive. These associations persisted after adjusting for sociodemographic factors. Similar trends in men in Yaoundé and women in Cotonou were not statistically significant. Increased schooling was associated with significantly decreased risk of HSV-2 infection in women in Kisumu and Ndola and men in Cotonou. In all the cities those with more education tended to report less risky sexual behaviour.
There was no evidence of an increased risk of HIV infection associated with education as seen in earlier studies. In each city there was some evidence of lower HIV or HSV-2 infection rates and less risky sexual behaviour associated with increased education levels. The most educated may be responding more readily to health education programmes. The challenge is to extend this to the rest of the population.
教育程度与艾滋病毒感染风险之间的关联在不同人群以及不同时期有所不同。撒哈拉以南非洲地区早期的研究发现，受教育程度较高者感染艾滋病毒的风险增加。
我们利用关于决定艾滋病毒在四个非洲城市不同传播因素的多中心研究数据，调查了普通教育与艾滋病毒和单纯疱疹病毒2型（HSV - 2）感染之间的关联。1997 - 1998年在科托努（贝宁）、雅温得（喀麦隆）、基苏木（肯尼亚）和恩多拉（赞比亚）开展了横断面普通人群研究，每个城市约有2000名成年人。
在基苏木或恩多拉，男性或女性的教育程度与艾滋病毒感染之间没有关联。雅温得的女性和科托努的男性受教育程度越高，感染艾滋病毒呈阳性的可能性越小。在对社会人口学因素进行调整后，这些关联仍然存在。雅温得男性和科托努女性的类似趋势在统计学上不显著。在基苏木和恩多拉的女性以及科托努的男性中，受教育程度提高与HSV - 2感染风险显著降低相关。在所有城市中，受教育程度较高者往往报告危险性行为较少。
没有证据表明如早期研究所显示的那样，教育会增加艾滋病毒感染风险。在每个城市，都有一些证据表明教育水平提高与艾滋病毒或HSV - 2感染率降低以及危险性行为减少有关。受教育程度最高的人群可能对健康教育项目反应更积极。挑战在于将这一情况推广到其他人群。
